Provider Demographics
NPI:1972569192
Name:SILVA, ANDREW BENEDICT (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:BENEDICT
Last Name:SILVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19455 DEERFIELD AVENUE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LANSDOWNE
Mailing Address - State:VA
Mailing Address - Zip Code:20176-8102
Mailing Address - Country:US
Mailing Address - Phone:703-858-4439
Mailing Address - Fax:703-858-4489
Practice Address - Street 1:19455 DEERFIELD AVENUE
Practice Address - Street 2:SUITE 301
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176-8102
Practice Address - Country:US
Practice Address - Phone:703-858-4439
Practice Address - Fax:703-858-4489
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101229009207YP0228X
MDD0080294207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA188793OtherBLUE CROSS BLUE SHIELD
VA1972569192Medicaid
VAP00406812OtherRR MEDICARE
VA1972569192Medicaid
MD563618ZY5JMedicare PIN
DC140867ZB8PMedicare PIN
VAP00406812OtherRR MEDICARE